levoleucovorin

What is the most important information I should know about levoleucovorin?

You should not receive this medication if you are allergic to levoleucovorin or to folic acid or folinic acid.

If possible, before you receive levoleucovorin, tell your doctor or caregivers if you have kidney or liver disease, or if you are dehydrated.

Tell your doctor if you are taking sulfa drugs, seizure medication, a cancer medication called fluorouracil (5FU), or a multivitamin or mineral supplement than contains folic acid.

In an emergency situation, it may not be possible before you are treated to tell your caregivers about all of your medical conditions or if you are pregnant or breast-feeding. However, make sure any doctor caring for you afterward knows that you have received this medication.

Tell your doctor or caregivers at once if you have fever, chills, white patches or sores inside your mouth or on your lips, severe or ongoing diarrhea, confusion, urination problems, or if you feel very thirsty or hot, if you are unable to urinate, and you have heavy sweating or hot and dry skin.

What is levoleucovorin?

Levoleucovorin is used to treat or prevent toxic effects of methotrexate in people who have received methotrexate to treat bone cancer.

Levoleucovorin is also used to treat or prevent toxic effects of methotrexate in people whose bodies do not eliminate methotrexate properly after the drug is metabolized. Levoleucovorin may also be used to treat toxic effects of an accidental overdose of methotrexate.

Levoleucovorin is also used in combination chemotherapy with fluorouracil (5-FU, Adrucil, Efudex, Carac, Fluoroplex) to treat colorectal cancer that has spread to other parts of the body. Levoleucovorin treats only the symptoms of colorectal cancer but does not treat the cancer itself.

Levoleucovorin should not be used to treat anemia that is caused by a lack of vitamin B12.

Levoleucovorin may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before I receive levoleucovorin?

You should not receive this medication if you are allergic to levoleucovorin or to folic acid or folinic acid.

If possible, before you receive levoleucovorin, tell your doctor or caregivers if you have:

kidney disease;

liver disease; or

if you are dehydrated.

FDA pregnancy category C. It is not known whether levoleucovorin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether levoleucovorin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using levoleucovorin.

In an emergency situation, it may not be possible before you are treated with levoleucovorin to tell your caregivers if you are pregnant or breast feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medication.

How is levoleucovorin given?

Levoleucovorin is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Levoleucovorin must be given slowly, and the IV infusion can take up to 4 hours to complete.

When treating or preventing methotrexate toxicity, levoleucovorin is usually given every 6 hours for 10 doses. You will most likely receive your first dose 24 hours after the start of your methotrexate infusion, or as soon as possible within the first 24 hours after accidental overdose.

After treatment with levoleucovorin, you will be watched to make sure the medication has been effective and you no longer have any effects of methotrexate.

When treating colorectal cancer levoleucovorin is usually given daily as a 5-day treatment, repeated every 4 to 5 weeks.

To be sure this medication is helping your condition and is not causing harmful effects, your blood will need to be tested often. This will help your doctor determine if your dose needs to be adjusted and how long to treat you with levoleucovorin. Visit your doctor regularly.

What happens if I miss a dose?

If this medication is given by a healthcare professional in an emergency setting, you are not likely to miss a dose.

If you are receiving levoleucovorin daily in 4-week treatment cycles, call your doctor for instructions if you miss an appointment for your scheduled injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving levoleucovorin?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

What are the possible side effects of levoleucovorin?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your doctor or caregivers at once if you have a serious side effect such as:

white patches or sores inside your mouth or on your lips;

urinating more or less than usual;

severe or ongoing diarrhea;

feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;

fever, chills;

confusion; or

trouble breathing.

Less serious side effects may include:

nausea, vomiting, diarrhea;

stomach pain, upset stomach;

numbness or tingling;

loss of appetite, unusual or unpleasant taste in your mouth;

weakness, tired feeling;

hair loss; or

mild skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect levoleucovorin?

The following drugs can interact with levoleucovorin. Tell your doctor if you are using any of these:

sulfa drugs (Bactrim, Septra, Sulfatrim, SMX-TMP, and others);

seizure medication such as phenobarbital (Solfoton), phenytoin (Dilantin), or primidone (Mysoline); or

a multivitamin or mineral supplement than contains folic acid.

This list is not complete and other drugs may interact with levoleucovorin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your doctor or pharmacist can provide more information about levoleucovorin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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